Disrupted physiological reactivity among children with a history of suicidal ideation: Moderation by parental expressed emotion-criticism

Abstract

Objective The goal of this study was to examine physiological reactivity during parent-child interactions in children with and without a history of suicidal ideation (SI), a group known to be at increased risk for suicidal thoughts and behaviors in the future. We also examined the potential moderating role of parental expressed emotion-criticism (EE-Crit) to determine whether the presence of parental criticism may help to identify a subgroup of children with a history of SI most at risk for physiological dysregulation. Method Participants were 396 children (age 7–11; 54% male, 71.7% Caucasian) and their biological parent. Children’s levels of high frequency heart rate variability (HF-HRV) were assessed during a resting baseline period followed by a positive and negative discussion with their parent. Additionally, parents completed the Five-Minute Speech Sample to determine levels of EE-Crit toward their child, and children completed an interview assessing their history of SI. Results Consistent with our hypothesis, we found that exposure to parental criticism moderated the relation between a child’s history of SI and their HF-HRV reactivity to the discussions. Specifically, while most children exhibited the typical pattern of HF-HRV suppression from baseline to both interactions, the highest risk children (i.e., children with a history of SI who also had highly critical parents) did not display any change in HF-HRV across the tasks, suggesting a failure to engage a typical psychophysiological response during emotional contexts. Conclusions These results suggest a specific physiological mechanism that may place these children at risk for suicidal thoughts and behaviors in the future.

Adolescent Suicide as a Failure of Acute Stress-Response Systems

“…For instance, in an early concurrent study, 23 adolescent females aged 14 to 18 years with a history of suicidal behavior or NSSI, or both, evinced lower resting RSA and excessive RSA withdrawal (i.e., greater release of SNS suppression) following exposure to evocative stimuli compared with controls (N = 23, ages 14-18 years) (Crowell et al 2005). Another study demonstrated that children ages 7-11 years with a history of suicidal ideation and who had parents rated high on expressed negative emotion did not show flexible RSA responses to a stressful discussion, suggesting a poor adaptive stress response (James et al 2017). Evidence from studies of adults also suggests that a lower resting RSA is associated with suicidal ideation (Rottenberg et al 2002) and distinguishes individuals with and without a history of suicide attempt (Tsypes et al 2018).…”

Neighborhood crime risk and resting respiratory sinus arrhythmia in middle childhood: Evidence of gender differences

“…Participants included 284 children between the ages of 7 and 11 years old recruited from the community as part of a larger study examining the NIMH Research Domain Criteria (National Institute of Mental Health, 2008) Negative Valence Systems in children (for details, see James, Woody, Feurer, Kudinova, & Gibb, 2017;Woody, Feurer, Sosoo, Hastings, & Gibb, 2016). Only one child per family was included for the current study.…”

Autonomic correlates of lifetime suicidal thoughts and behaviors among adolescents with a history of depression

“…For example, compared to nonsuicidal women with a history of depression, those who also had attempted suicide displayed reduced RSA reactivity to a laboratory stressor (Wilson et al, ). Likewise, James et al () found that children with a history of suicidal ideation did not exhibit the typical RSA decrease during a (presumably stressful) parent‐child interaction task. However, suicidal adolescents also have been reported to exhibit greater decrease in RSA than controls when responding to a sad film (Crowell et al, ) as well as laboratory stressors (Giletta et al, ; Kaufman et al, ).…”

“…In summary, emotion regulation is considered as a key to understanding STBs, which can be studied using physiological measures. However, most work in this area has focused on suicidal ideation or suicide attempts (e.g., Chang et al, ; Crowell et al, ; Giletta et al, ; James et al, ; Wilson et al, ), while the Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV; American Psychiatric Association, ) specifies four categories of STBs: recurrent thoughts of death, recurrent suicidal ideation, suicide plan, and suicide attempt. Therefore, in the present study, we sought to address the full range of STBs.…”

“…Depression has been generally associated with low resting RSA and attenuated RSA reactivity to both stressful and affective stimuli (Bylsma, Salomon, Taylor-Clift, Morris, & Rottenberg, 2014;Kemp, Quintana, Quinn, Hopkinson, & Harris, 2014;Licht et al, 2008;Yaroslavsky, Rottenberg, & Kovacs, 2014;but see Hastings, Klimes-Dougan, Kendziora, Brand, & Zahn-Waxler, 2014). Low resting RSA and attenuated RSA reactivity to laboratory stressors have also been observed among individuals with a history of STBs (Chang et al, 2013;Forkmann et al, 2016;James, Woody, Feurer, Kudinova, & Gibb, 2017;Rottenberg, Wilhelm, Gross, & Gotlib, 2002;Tsypes et al, 2018;Wilson et al, 2016). For example, compared to nonsuicidal women with a history of depression, those who also had attempted suicide displayed reduced RSA reactivity to a laboratory stressor (Wilson et al, 2016).…”